Search results for: probability-driven health outcome predictions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11168

Search results for: probability-driven health outcome predictions

11078 Clinical Profile and Outcome of Type I Diabetes Mellitus at a Tertiary Care-Centre in Eastern Nepal

Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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11077 Evaluating the Suitability and Performance of Dynamic Modulus Predictive Models for North Dakota’s Asphalt Mixtures

Authors: Duncan Oteki, Andebut Yeneneh, Daba Gedafa, Nabil Suleiman

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Most agencies lack the equipment required to measure the dynamic modulus (|E*|) of asphalt mixtures, necessitating the need to use predictive models. This study compared measured |E*| values for nine North Dakota asphalt mixes using the original Witczak, modified Witczak, and Hirsch models. The influence of temperature on the |E*| models was investigated, and Pavement ME simulations were conducted using measured |E*| and predictions from the most accurate |E*| model. The results revealed that the original Witczak model yielded the lowest Se/Sy and highest R² values, indicating the lowest bias and highest accuracy, while the poorest overall performance was exhibited by the Hirsch model. Using predicted |E*| as inputs in the Pavement ME generated conservative distress predictions compared to using measured |E*|. The original Witczak model was recommended for predicting |E*| for low-reliability pavements in North Dakota.

Keywords: asphalt mixture, binder, dynamic modulus, MEPDG, pavement ME, performance, prediction

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11076 Self-Inflicted Major Trauma: Inpatient Mental Health Management and Patient Outcomes

Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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11075 Identification of CLV for Online Shoppers Using RFM Matrix: A Case Based on Features of B2C Architecture

Authors: Riktesh Srivastava

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Online Shopping have established an astonishing evolution in the last few years. And it is now apparent that B2C architecture is becoming progressively imperative channel for even traditional brick and mortar type traders as well. In this completion knowing customers and predicting behavior are extremely important. More important, when any customer logs onto the B2C architecture, the traces of their buying patterns can be stored and used for future predictions. Such a prediction is called Customer Lifetime Value (CLV). Earlier, we used Net Present Value to do so, however, it ignores two important aspects of B2C architecture, “market risks” and “big amount of customer data”. Now, we use RFM- Recency, Frequency and Monetary Value to estimate the CLV, and as the term exemplifies, market risks, is well sheltered. Big Data Analysis is also roofed in RFM, which gives real exploration of the Big Data and lead to a better estimation for future cash flow from customers. In the present paper, 6 factors (collected from varied sources) are used to determine as to what attracts the customers to the B2C architecture. For these 6 factors, RFM is computed for 3 years (2013, 2014 and 2015) respectively. CLV and Revenue are the two parameters defined using RFM analysis, which gives the clear picture of the future predictions.

Keywords: CLV, RFM, revenue, recency, frequency, monetary value

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11074 Oil Reservoir Asphalting Precipitation Estimating during CO2 Injection

Authors: I. Alhajri, G. Zahedi, R. Alazmi, A. Akbari

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In this paper, an Artificial Neural Network (ANN) was developed to predict Asphaltene Precipitation (AP) during the injection of carbon dioxide into crude oil reservoirs. In this study, the experimental data from six different oil fields were collected. Seventy percent of the data was used to develop the ANN model, and different ANN architectures were examined. A network with the Trainlm training algorithm was found to be the best network to estimate the AP. To check the validity of the proposed model, the model was used to predict the AP for the thirty percent of the data that was unevaluated. The Mean Square Error (MSE) of the prediction was 0.0018, which confirms the excellent prediction capability of the proposed model. In the second part of this study, the ANN model predictions were compared with modified Hirschberg model predictions. The ANN was found to provide more accurate estimates compared to the modified Hirschberg model. Finally, the proposed model was employed to examine the effect of different operating parameters during gas injection on the AP. It was found that the AP is mostly sensitive to the reservoir temperature. Furthermore, the carbon dioxide concentration in liquid phase increases the AP.

Keywords: artificial neural network, asphaltene, CO2 injection, Hirschberg model, oil reservoirs

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11073 The Use of Respiratory Index of Severity in Children (RISC) for Predicting Clinical Outcomes for 3 Months-59 Months Old Patients Hospitalized with Community-Acquired Pneumonia in Visayas Community Medical Center, Cebu City from January 2013 - June 2

Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

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Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

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11072 Transfer Learning for Protein Structure Classification at Low Resolution

Authors: Alexander Hudson, Shaogang Gong

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Structure determination is key to understanding protein function at a molecular level. Whilst significant advances have been made in predicting structure and function from amino acid sequence, researchers must still rely on expensive, time-consuming analytical methods to visualise detailed protein conformation. In this study, we demonstrate that it is possible to make accurate (≥80%) predictions of protein class and architecture from structures determined at low (>3A) resolution, using a deep convolutional neural network trained on high-resolution (≤3A) structures represented as 2D matrices. Thus, we provide proof of concept for high-speed, low-cost protein structure classification at low resolution, and a basis for extension to prediction of function. We investigate the impact of the input representation on classification performance, showing that side-chain information may not be necessary for fine-grained structure predictions. Finally, we confirm that high resolution, low-resolution and NMR-determined structures inhabit a common feature space, and thus provide a theoretical foundation for boosting with single-image super-resolution.

Keywords: transfer learning, protein distance maps, protein structure classification, neural networks

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11071 Verification and Application of Finite Element Model Developed for Flood Routing in Rivers

Authors: A. L. Qureshi, A. A. Mahessar, A. Baloch

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Flood wave propagation in river channel flow can be enunciated by nonlinear equations of motion for unsteady flow. However, it is difficult to find analytical solution of these complex non-linear equations. Hence, verification of the numerical model should be carried out against field data and numerical predictions. This paper presents the verification of developed finite element model applying for unsteady flow in the open channels. The results of a proposed model indicate a good matching with both Preissmann scheme and HEC-RAS model for a river reach of 29 km at both sites (15 km from upstream and at downstream end) for discharge hydrographs. It also has an agreeable comparison with the Preissemann scheme for the flow depth (stage) hydrographs. The proposed model has also been applying to forecast daily discharges at 400 km downstream from Sukkur barrage, which demonstrates accurate model predictions with observed daily discharges. Hence, this model may be utilized for predicting and issuing flood warnings about flood hazardous in advance.

Keywords: finite element method, Preissmann scheme, HEC-RAS, flood forecasting, Indus river

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11070 Impact of Rapid Urbanization on Health Sector in India

Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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11069 Surgical Outcome of Heavy Silicone Oil in Rhegmatogenous Retinal Detachment

Authors: Pheeraphat Ussadamongkol, Suthasinee Sinawat

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Objective: The purpose of this study is to evaluate the anatomical and visual outcomes associated with the use of heavy silicone oil (HSO) during pars plana vitrectomy (PPV) in patients with rhegmatogenous retinal detachment (RRD). Materials and methods: A Total of 66 eyes of 66 patients with RRD patients who underwent PPV with HSO from 2018-2023 were included in this retrospective study. Risk factors of surgical outcomes were also investigated. Results: The mean age of the recruited patients was 55.26 ± 13.05 years. The most common diagnosis was recurrent RRD, with 43 patients (65.15%), and the majority of these patients (81.39%) had a history of multiple vitreoretinal surgeries. Inferior breaks and PVR grade ≧ C were present in 65.15% and 42.42% of cases, respectively. The mean duration of HSO tamponade was 7.77+5.19 months. The retinal attachment rate after surgery was 71.21%, with a final attachment rate of 87.88%. The mean final VA was 1.62 ± 1.11 logMAR. 54.54% of patients could achieve a final visual acuity (VA)  6/60. Multivariate analysis revealed that proliferative vitreoretinopathy (PVR) and multiple breaks were significantly associated with retinal redetachment, while initial good VA (  6/60) was associated with good visual outcome ( 6/60). The most common complications were glaucoma (30.3%) and epimacular membrane (7.58%). Conclusion: The use of heavy silicone oil in pars plana vitrectomy for rhegmatogenous retinal detachment yields favorable anatomical and visual outcomes. Factors associated with retinal redetachment are proliferative vitreoretinopathy and multiple breaks. Good initial VA can predict good visual outcomes.

Keywords: rhegmatogenous retinal detachment, heavy silicone oil, surgical outcome, visual outcome, risk factors

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11068 A Trend Based Forecasting Framework of the ATA Method and Its Performance on the M3-Competition Data

Authors: H. Taylan Selamlar, I. Yavuz, G. Yapar

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It is difficult to make predictions especially about the future and making accurate predictions is not always easy. However, better predictions remain the foundation of all science therefore the development of accurate, robust and reliable forecasting methods is very important. Numerous number of forecasting methods have been proposed and studied in the literature. There are still two dominant major forecasting methods: Box-Jenkins ARIMA and Exponential Smoothing (ES), and still new methods are derived or inspired from them. After more than 50 years of widespread use, exponential smoothing is still one of the most practically relevant forecasting methods available due to their simplicity, robustness and accuracy as automatic forecasting procedures especially in the famous M-Competitions. Despite its success and widespread use in many areas, ES models have some shortcomings that negatively affect the accuracy of forecasts. Therefore, a new forecasting method in this study will be proposed to cope with these shortcomings and it will be called ATA method. This new method is obtained from traditional ES models by modifying the smoothing parameters therefore both methods have similar structural forms and ATA can be easily adapted to all of the individual ES models however ATA has many advantages due to its innovative new weighting scheme. In this paper, the focus is on modeling the trend component and handling seasonality patterns by utilizing classical decomposition. Therefore, ATA method is expanded to higher order ES methods for additive, multiplicative, additive damped and multiplicative damped trend components. The proposed models are called ATA trended models and their predictive performances are compared to their counter ES models on the M3 competition data set since it is still the most recent and comprehensive time-series data collection available. It is shown that the models outperform their counters on almost all settings and when a model selection is carried out amongst these trended models ATA outperforms all of the competitors in the M3- competition for both short term and long term forecasting horizons when the models’ forecasting accuracies are compared based on popular error metrics.

Keywords: accuracy, exponential smoothing, forecasting, initial value

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11067 Evaluation Methods for Question Decomposition Formalism

Authors: Aviv Yaniv, Ron Ben Arosh, Nadav Gasner, Michael Konviser, Arbel Yaniv

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This paper introduces two methods for the evaluation of Question Decomposition Meaning Representation (QDMR) as predicted by sequence-to-sequence model and COPYNET parser for natural language questions processing, motivated by the fact that previous evaluation metrics used for this task do not take into account some characteristics of the representation, such as partial ordering structure. To this end, several heuristics to extract such partial dependencies are formulated, followed by the hereby proposed evaluation methods denoted as Proportional Graph Matcher (PGM) and Conversion to Normal String Representation (Nor-Str), designed to better capture the accuracy level of QDMR predictions. Experiments are conducted to demonstrate the efficacy of the proposed evaluation methods and show the added value suggested by one of them- the Nor-Str, for better distinguishing between high and low-quality QDMR when predicted by models such as COPYNET. This work represents an important step forward in the development of better evaluation methods for QDMR predictions, which will be critical for improving the accuracy and reliability of natural language question-answering systems.

Keywords: NLP, question answering, question decomposition meaning representation, QDMR evaluation metrics

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11066 An Overview of Explainable AI Methods for Diagnosing Brain Diseases

Authors: Nighat Bibi

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In recent years, there has been a significant increase in the use of AI models in healthcare. These models have been demonstrated to produce high accuracy in disease diagnosis and classification; however, they do not reveal the reasoning behind their predictions. Their black-box nature makes them untrustworthy for medical diagnosis. However, eXplainable Artificial Intelligence (XAI) techniques help determine the basis on which AI models make predictions. This review paper provides an overview of research conducted in the field of XAI for diagnosing, detecting, and classifying brain diseases such as brain tumours, Alzheimer’s disease, dementia, Parkinson’s disease, stroke, epilepsy, and autism spectrum disorder (ASD). It also highlights the importance of XAI techniques and the significance of the research being conducted in this field. Finally, we discuss the limitations of current XAI techniques and future research directions. This study can help doctors, researchers, and policymakers interested in the interpretability and explainability of AI models in diagnosing brain diseases.

Keywords: autism spectrum disorder, brain tumour, computer-aided diagnosis, dementia, epilepsy, explainability, explainable AI, interpretability, Parkinson’s disease, stroke, transparency

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11065 Assessing the Influence of Station Density on Geostatistical Prediction of Groundwater Levels in a Semi-arid Watershed of Karnataka

Authors: Sakshi Dhumale, Madhushree C., Amba Shetty

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The effect of station density on the geostatistical prediction of groundwater levels is of critical importance to ensure accurate and reliable predictions. Monitoring station density directly impacts the accuracy and reliability of geostatistical predictions by influencing the model's ability to capture localized variations and small-scale features in groundwater levels. This is particularly crucial in regions with complex hydrogeological conditions and significant spatial heterogeneity. Insufficient station density can result in larger prediction uncertainties, as the model may struggle to adequately represent the spatial variability and correlation patterns of the data. On the other hand, an optimal distribution of monitoring stations enables effective coverage of the study area and captures the spatial variability of groundwater levels more comprehensively. In this study, we investigate the effect of station density on the predictive performance of groundwater levels using the geostatistical technique of Ordinary Kriging. The research utilizes groundwater level data collected from 121 observation wells within the semi-arid Berambadi watershed, gathered over a six-year period (2010-2015) from the Indian Institute of Science (IISc), Bengaluru. The dataset is partitioned into seven subsets representing varying sampling densities, ranging from 15% (12 wells) to 100% (121 wells) of the total well network. The results obtained from different monitoring networks are compared against the existing groundwater monitoring network established by the Central Ground Water Board (CGWB). The findings of this study demonstrate that higher station densities significantly enhance the accuracy of geostatistical predictions for groundwater levels. The increased number of monitoring stations enables improved interpolation accuracy and captures finer-scale variations in groundwater levels. These results shed light on the relationship between station density and the geostatistical prediction of groundwater levels, emphasizing the importance of appropriate station densities to ensure accurate and reliable predictions. The insights gained from this study have practical implications for designing and optimizing monitoring networks, facilitating effective groundwater level assessments, and enabling sustainable management of groundwater resources.

Keywords: station density, geostatistical prediction, groundwater levels, monitoring networks, interpolation accuracy, spatial variability

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11064 Treatment Outcome of Cutaneous Leishmaniasis and Its Associated Factors among Admitted Patients in All Africa Leprosy Rehabilitation and Training Center Hospital, Ethiopia

Authors: Kebede Mairie, Getahun Belete, Mitike Abeba

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Background: Leishmania aethiopica is a peculiar parasite causing cutaneous leishmaniasis in Ethiopia and its mainstay treatment is Sodium Stibogluconate. However, its treatment outcome in Ethiopia is not well documented. Objectives: To determine the treatment outcome of admitted cutaneous leishmaniasis patients and its associated factors in Addis Ababa, Ethiopia. Methods: A retrospective study was conducted from 1st November 2021 to 30th March 2022. Medical records of all cutaneous leishmaniasis-diagnosed and admitted patients who received parenteral sodium stibogluconate at All Africa Leprosy Rehabilitation and Training Center (ALERT) hospital, the main Leishmania treatment center in Ethiopia from July 2011 to September 2021 were reviewed. Results: A total of 827 charts of admitted cases from July 2011 to September 2021 were retrieved, but 667 (80.65%) were reviewed. Improvement in the treatment outcome was recorded in 93.36 % in the first course of SSG treatment and 96.23%, 94.62%, and 96.97% subsequently in the second, third and fourth treatment courses, respectively. Female gender and diffuse cutaneous leishmaniasis were the two predictive determinants in the treatment of cutaneous leishmaniasis. Conclusion: The study shows that parenteral sodium stibogluconate therapy treats hospitalized cutaneous leishmaniasis patients well, with female gender and diffuse cutaneous leishmaniasis having poor outcomes suggesting the need for a different approach for diffuse cutaneous leishmaniasis patients.

Keywords: cutaneous leishmaniasis, leishmania aethiopica, sodium stibogluconate, diffuse cutaneous leishmaniasis, pentostam

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11063 The Effect of Diet Intervention for Breast Cancer: A Meta-Analysis

Authors: Bok Yae Chung, Eun Hee Oh

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Breast cancer patients require more nutritional interventions than others. However, a few studies have attempted to assess the overall nutritional status, to reduce body weight and BMI by improving diet, and to improve the prognosis of cancer for breast cancer patients. The purpose of this study was to evaluate the effect of diet intervention in the breast cancer patients through meta-analysis. For the study purpose, 16 studies were selected by using PubMed, ScienceDirect, ProQuest and CINAHL. Meta-analysis was performed using a random-effects model, and the effect size on outcome variables in breast cancer was calculated. The effect size for outcome variables of diet intervention was a large effect size. For heterogeneity, moderator analysis was performed using intervention type and intervention duration. All moderators did not significant difference. Diet intervention has significant positive effects on outcome variables in breast cancer. As a result, it is suggested that the timing of the intervention should be no more than six months, but a strategy for sustaining long-term intervention effects should be added if nutritional intervention is to be administered for breast cancer patients in the future.

Keywords: breast cancer, diet, mete-analysis, intervention

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11062 Preoperative 3D Planning and Reconstruction of Mandibular Defects for Patients with Oral Cavity Tumors

Authors: Janis Zarins, Kristaps Blums, Oskars Radzins, Renars Deksnis, Atis Svare, Santa Salaka

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Wide tumor resection remains the first choice method for tumors of the oral cavity. Nevertheless, remained tissue defect impacts patients functional and aesthetical outcome, which could be improved using microvascular tissue transfers. Mandibular reconstruction is challenging due to the complexity of composite tissue defects and occlusal relationships for normal eating, chewing, and pain free jaw motions. Individual 3-D virtual planning would provide better symmetry and functional outcome. The main goal of preoperative planning is to develop a customized surgical approach with patient specific cutting guides of the mandible, osteotomy guides of the fibula, pre-bended osteosynthesis plates to perform more precise reconstruction, to decrease the surgery time and reach the best outcome. Our study is based on the analysis of 32 patients operated on between 2019 to 2021. All patients underwent mandible reconstruction with vascularized fibula flaps. Patients characteristics, surgery profile, survival, functional outcome, and quality of life was evaluated. Preoperative planning provided a significant decrease of surgery time and the best arrangement of bone closely similar as before the surgery. In cases of bone asymmetry, deformity and malposition, a new mandible was created using 3D planning to restore the appearance of lower jaw anatomy and functionality.

Keywords: mandibular, 3D planning, cutting guides, fibula flap, reconstruction

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11061 Work Engagement, Sense of Humor and Workplace Outcomes: The Mediating Role of Psychological Capital

Authors: Vandana Maurya

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Positive psychological capital is the key contributor to the competitive advantage of the organizations. Moreover, work engagement and sense of humor are also positive notions and are able to facilitate positive workplace behaviour but the mechanism behind these relationships are not well understood. The purpose of this study was to examine the relationships among work engagement, sense of humor and outcome variables (organizational citizenship behaviour and ethical performance) as well as investigating how psychological capital (PsyCap) mediates the relationships between work engagement, sense of humor and the outcome variables among healthcare professionals. A cross-sectional survey was conducted on healthcare professionals (n= 240). Data were collected using questionnaires which includes Utrecht Work Engagement Scale (UWES), Multi-dimensional Sense of Humor Scale (MSHS), Psychological Capital Questionnaire (PCQ), Organizational Citizenship Behavior Questionnaire, and Ethical Performance Scale (EPS). The results of the regression analyses showed that work engagement and sense of humor both positively predicted the outcome variables. Mediation analysis reveals that psychological capital mediates the relationship between predictor and outcome variables. The study recommends that the framework presented in this study can be an important tool for managers to enhance their employees’ psychological capital by increasing their levels of work engagement and sense of humor. In turn, psychological capital could be a positive resource for employees to dealing more ethically and enhancing more positive workplace behaviour.

Keywords: ethical performance, humor, organizational citizenship behavior, PsyCap, work engagement

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11060 Differential Impact of Parenting on Mental Health Functioning of Pakistani Adolescents: A Cultural Perspective

Authors: Zahid Mahmood

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Mental health problems in adolescents are said to be increasing tremendously, and a large proportion of adolescents are suffering from serious mental health problems that result in short and long term socio-emotional negative consequences. Contemporary clinical and school psychology is now focused on prevention rather than intervene in the mental health concerns of adolescents. Therefore, a wealth of literature is devoted to identify the risk and protective factors so that adolescents may be prevented and identified earlier. This quest has led to identify many risk factors including the early parent-child relationship. Parenting has a long last impact on the growth and development of an individual. If the parent-child relationship is secure and warm, the child tends to have a positive psychological outcome. On the other hand, if parenting is rejecting and distant, it may lead to more mental health problems. Keeping in view the cross-cultural influence of parenting, the current study was aimed to explore the relationship between parental rearing practices and mental health problems on a group of Pakistani adolescents. A sample of 805 participants (49% boys and 51% girls) were selected through a stratified sample with the age range of 13-18 years. All the participants were given protocol of EMBU-C and School Children Problem Scale (SCPS). Results indicate that age, the gender of the participant and parental rejection were found to be a significant positive predictor of mental health problems in adolescents. It can be concluded that parenting may be a universal phenomenon comprising rejection and acceptance yet the differential impact on mental health varies from culture to culture.

Keywords: parenting, mental health, adolescents, cross cultural

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11059 Contribution of Automated Early Warning Score Usage to Patient Safety

Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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11058 Comparison of Visual Acuity Outcome and Complication after Phacoemulsification between Diabetic and Non-Diabetic Patients at Burapha University Hospital, Chonburi, Thailand

Authors: Luksanaporn Krungkraipetch

Abstract:

One hundred cataract patients with phacoemulsification were enrolled in the study to compare of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients at Burapha University Hospital, Chonburi, Thailand. Fifty patients were diabetic (type II) group and 50 patients were non-diabetic group. All cases were operated by one doctor with the same pre-operative care, operation (phacoemulsification), and post-operative care. Visual acuity and complication after surgery were assessed after the operation for two years. There were no significant differences in demographic data between the two groups. The visual outcome values ≥ 2 lines and ≥ 20/40 had no significant differences between two groups after two years of surgery. The complication rate in diabetic group had cystoid macular edema 16%, rupture posterior capsule 8%, posterior capsule opacity 2%, uveitis 2 %, and 2% endophthalmitis. The non-diabetic group had cystoid macular edema 12%, rupture posterior capsule 8%, uveitis 2%, posterior capsule opacity 2%, and 2% wound leak. Comparison of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients had no statistical significant differences between these two groups. It was found that cystoid macular edema was the most common complication in both groups and 10% of retinopathy progression was seen.

Keywords: cataract, visual acuity, cataract extraction, phacoemulsification, diabetic retinopathy

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11057 Lying in a Sender-Receiver Deception Game: Effects of Gender and Motivation to Deceive

Authors: Eitan Elaad, Yeela Gal-Gonen

Abstract:

Two studies examined gender differences in lying when the truth-telling bias prevailed and when inspiring lying and distrust. The first study used 156 participants from the community (78 pairs). First, participants completed the Narcissistic Personality Inventory, the Lie- and Truth Ability Assessment Scale (LTAAS), and the Rational-Experiential Inventory. Then, they participated in a deception game where they performed as senders and receivers of true and false communications. Their goal was to retain as many points as possible according to a payoff matrix that specified the reward they would gain for any possible outcome. Results indicated that males in the sender position lied more and were more successful tellers of lies and truths than females. On the other hand, males, as receivers, trusted less than females but were not better at detecting lies and truths. We explained the results by a. Male's high perceived lie-telling ability. We observed that confidence in telling lies guided participants to increase their use of lies. Male's lie-telling confidence corresponded to earlier accounts that showed a consistent association between high self-assessed lying ability, reports of frequent lying, and predictions of actual lying in experimental settings; b. Male's narcissistic features. Earlier accounts described positive relations between narcissism and reported lying or unethical behavior in everyday life situations. Predictions about the association between narcissism and frequent lying received support in the present study. Furthermore, males scored higher than females on the narcissism scale; and c. Male's experiential thinking style. We observed that males scored higher than females on the experiential thinking style scale. We further hypothesized that the experiential thinking style predicts frequent lying in the deception game. Results confirmed the hypothesis. The second study used one hundred volunteers (40 females) who underwent the same procedure. However, the payoff matrix encouraged lying and distrust. Results showed that male participants lied more than females. We found no gender differences in trust. Males and females did not differ in their success of telling and detecting lies and truths. Participants also completed the LTAAS questionnaire. Males assessed their lie-telling ability higher than females, but the ability assessment did not predict lying frequency. A final note. The present design is limited to low stakes. Participants knew that they were participating in a game, and they would not experience any consequences from their deception in the game. Therefore, we advise caution when applying the present results to lying under high stakes.

Keywords: gender, lying, detection of deception, information processing style, self-assessed lying ability

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11056 Disability Management and Occupational Health Enhancement Program in Hong Kong Hospital Settings

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

Abstract:

Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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11055 Socioeconomic and Demographic Factors Influencing Male Antenatal Care Participation in Zimbabwe

Authors: Lucia Mavudzi

Abstract:

Socioeconomic and demographic factors influence male attendance of antenatal care (ANC) activities which are beneficial in improving maternal health and birth outcome. When a male, as the head of the family is expected to solely make decisions of how finances are managed, when and where health services are sought, it impacts on the woman’s health seeking behavior. Using the data from the Zimbabwe Demographic and Health Survey 2010-2011 this paper seeks to assess the prevalence of male ANC attendance in Zimbabwe and factors that influence male ANC attendance. We hypothesized that socioeconomic and demographic factors do not influence male ANC attendance. To achieve the objectives of this paper, descriptive analysis was used to describe the characteristics of men and the Binomial logistic modelling was used to assess the relationship between male ANC attendance and selected socioeconomic and demographic factors. Male ANC attendance was used as the dependent variable, and the independent variables are age, marital status, place of residence, wealth, education, religion and employment. A high percentage of males did not attend ANC with their pregnant partners. Religion, education, and place of residence were found to be significantly associated with male ANC attendance. There was no evidence to show that there was a difference in male ANC attendance by employment, marital status, and age. Findings from this paper are relevant to public health. They will be used to develop strategies and intervention programs to improve pregnant women’s attendance of ANC attendance by involving men in maternal health.

Keywords: antenatal care, male participation, maternal health, socio-economic and demographic factors

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11054 Creep Analysis and Rupture Evaluation of High Temperature Materials

Authors: Yuexi Xiong, Jingwu He

Abstract:

The structural components in an energy facility such as steam turbine machines are operated under high stress and elevated temperature in an endured time period and thus the creep deformation and creep rupture failure are important issues that need to be addressed in the design of such components. There are numerous creep models being used for creep analysis that have both advantages and disadvantages in terms of accuracy and efficiency. The Isochronous Creep Analysis is one of the simplified approaches in which a full-time dependent creep analysis is avoided and instead an elastic-plastic analysis is conducted at each time point. This approach has been established based on the rupture dependent creep equations using the well-known Larson-Miller parameter. In this paper, some fundamental aspects of creep deformation and the rupture dependent creep models are reviewed and the analysis procedures using isochronous creep curves are discussed. Four rupture failure criteria are examined from creep fundamental perspectives including criteria of Stress Damage, Strain Damage, Strain Rate Damage, and Strain Capability. The accuracy of these criteria in predicting creep life is discussed and applications of the creep analysis procedures and failure predictions of simple models will be presented. In addition, a new failure criterion is proposed to improve the accuracy and effectiveness of the existing criteria. Comparisons are made between the existing criteria and the new one using several examples materials. Both strain increase and stress relaxation form a full picture of the creep behaviour of a material under high temperature in an endured time period. It is important to bear this in mind when dealing with creep problems. Accordingly there are two sets of rupture dependent creep equations. While the rupture strength vs LMP equation shows how the rupture time depends on the stress level under load controlled condition, the strain rate vs rupture time equation reflects how the rupture time behaves under strain-controlled condition. Among the four existing failure criteria for rupture life predictions, the Stress Damage and Strain Damage Criteria provide the most conservative and non-conservative predictions, respectively. The Strain Rate and Strain Capability Criteria provide predictions in between that are believed to be more accurate because the strain rate and strain capability are more determined quantities than stress to reflect the creep rupture behaviour. A modified Strain Capability Criterion is proposed making use of the two sets of creep equations and therefore is considered to be more accurate than the original Strain Capability Criterion.

Keywords: creep analysis, high temperature mateials, rapture evalution, steam turbine machines

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11053 Extending Theory of Planned Behavior to Modelling Chronic Patients’ Acceptance of Health Information: An Information Overload Perspective

Authors: Shu-Lien Chou, Chung-Feng Liu

Abstract:

Self-health management of chronic illnesses plays an important part in chronic illness treatments. However, various kinds of health information (health education materials) which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients’ use intention could be patients’ perceived Information overload regarding the health information. This study proposed an extended model of Theory of Planned Behavior, which integrating perceived information overload as another construct to explore patients’ use intention of the health information for self-health management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the health information. The cross-sectional study used a structured questionnaire for data collection, focusing on the chronic patients with coronary artery disease (CAD), who are the potential users of the health information, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the questionnaire respondents, and the Partial Least Squares (PLS) structural equation model to study the reliability and construct validity for testing our hypotheses. A total of 110 patients were enrolled in this study and 106 valid questionnaires were collected. The PLS analysis result indicates that the patients’ perceived information overload of health information contributes the most critical factor influencing the behavioral intention. Subjective norm and perceived behavioral control of TPB constructs had significant effects on patients’ intentions to use health information also, whereas the attitude construct did not. This study demonstrated a comprehensive framework, which extending perceived information overload into TPB model to predict patients’ behavioral intention of using heath information. We expect that the results of this study will provide useful insights for studying health information from the perspectives of academia, governments, and healthcare providers.

Keywords: chronic patients, health information, information overload, theory of planned behavior

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11052 Working Title: Estimating the Power Output of Photovoltaics in Kuwait Using a Monte Carlo Approach

Authors: Mohammad Alshawaf, Rahmat Poudineh, Nawaf Alhajeri

Abstract:

The power generated from photovoltaic (PV) modules is non-dispatchable on demand due to the stochastic nature of solar radiation. The random variations in the measured intensity of solar irradiance are due to clouds and, in the case of arid regions, dust storms which decrease the intensity of intensity of solar irradiance. Therefore, modeling PV power output using average, maximum, or minimum solar irradiance values is inefficient to predict power generation reliably. The overall objective of this paper is to predict the power output of PV modules using Monte Carlo approach based the weather and solar conditions measured in Kuwait. Given the 250 Wp PV module used in study, the average daily power output is 1021 Wh/day. The maximum power was generated in April and the minimum power was generated in January 1187 Wh/day and 823 Wh/day respectively. The certainty of the daily predictions varies seasonally and according to the weather conditions. The output predictions were far more certain in the summer months, for example, the 80% certainty range for August is 89 Wh/day, whereas the 80% certainty range for April is 250 Wh/day.

Keywords: Monte Carlo, solar energy, variable renewable energy, Kuwait

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11051 Design Systems and the Need for a Usability Method: Assessing the Fitness of Components and Interaction Patterns in Design Systems Using Atmosphere Methodology

Authors: Patrik Johansson, Selina Mardh

Abstract:

The present study proposes a usability test method, Atmosphere, to assess the fitness of components and interaction patterns of design systems. The method covers the user’s perception of the components of the system, the efficiency of the logic of the interaction patterns, perceived ease of use as well as the user’s understanding of the intended outcome of interactions. These aspects are assessed by combining measures of first impression, visual affordance and expectancy. The method was applied to a design system developed for the design of an electronic health record system. The study was conducted involving 15 healthcare personnel. It could be concluded that the Atmosphere method provides tangible data that enable human-computer interaction practitioners to analyze and categorize components and patterns based on perceived usability, success rate of identifying interactive components and success rate of understanding components and interaction patterns intended outcome.

Keywords: atomic design, atmosphere methodology, design system, expectancy testing, first impression testing, usability testing, visual affordance testing

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11050 Survival Data with Incomplete Missing Categorical Covariates

Authors: Madaki Umar Yusuf, Mohd Rizam B. Abubakar

Abstract:

The survival censored data with incomplete covariate data is a common occurrence in many studies in which the outcome is survival time. With model when the missing covariates are categorical, a useful technique for obtaining parameter estimates is the EM by the method of weights. The survival outcome for the class of generalized linear model is applied and this method requires the estimation of the parameters of the distribution of the covariates. In this paper, we propose some clinical trials with ve covariates, four of which have some missing values which clearly show that they were fully censored data.

Keywords: EM algorithm, incomplete categorical covariates, ignorable missing data, missing at random (MAR), Weibull Distribution

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11049 The Carers-ID Online Intervention For Family Carers Of People With Intellectual Disabilities: A Feasibility Trial Protocol

Authors: Mark Linden, Rachel Leonard, Trisha Forbes, Michael Brown, Lynne Marsh, Stuart Todd, Nathan Hughes, Maria Truesdale

Abstract:

Background: Current interventions which aim to improve the mental health of family carers are often face to face, which can create barriers to full participation. Online interventions can offer flexibility in delivery compared to face to face approaches. The primary objective of this study is to determine the feasibility of delivering the Carers-ID online intervention, while the secondary outcome is to improve the mental health of family carers of people with intellectual disabilities. Methods: Family carers (n = 120) will be randomised to receive the intervention (n=60) or assigned to a wait-list control (n=60) group. The intervention (www.Carers-ID.com) consists of fourteen modules which cover topics including promoting resilience, providing peer support, reducing anxiety, managing stress, accessing local supports, managing family conflict and information for siblings who are carers. Primary outcomes for this study include acceptability and feasibility of the outcome measures, recruitment, participation and retention rates and effect sizes. Secondary outcomes will be completed at three time points (baseline, following intervention completion and three months after completion). Secondary outcomes include, depression, anxiety, stress, well-being , resilience and social connectedness. Participants (n=12) who have taken part in the intervention arm of the research will be invited to participate in semi-structured interviews as part of the process evaluation. Discussion: To determine whether a full-scale randomised controlled effectiveness trial is warranted, feasibility testing of the intervention and trial procedures is a necessary first step. The Carers-ID intervention provides an accessible resource for family carers to support their mental health and well-being.

Keywords: intellectual disability, family carer, feasibility trial, online intervention

Procedia PDF Downloads 75